Effects of Home-Based Supportive Care on Improvements in Physical Function and Depressive Symptoms in Patients With Stroke: A Meta-Analysis

Abstract

Objective: To examine the effects of home-based supportive care on improvements in physical function and depressive symptoms in home-dwelling patients after stroke.

Data sources: Seven electronic databases (eg, MEDLINE, PubMed, CINAL, EMBASE, the Cochrane Central Register of Controlled Trials, ProQuest, and Google Scholar) and 4 Chinese databases (eg, WANFANG MED ONLINE, Chinese Electronic Periodical Services, China Academic Journals Full-text Database, and National Central Library) were fully searched for all relevant articles up to June 25, 2016.

Study selection: Randomized controlled trials examining the effects of home-based supportive care on physical function and depressive symptoms in home-dwelling patients after stroke were included. Finally, 16 articles in Chinese (n=4) and English (n=12) met the inclusion criteria.

Data extraction: Data on patient characteristics, study characteristics, intervention details, and outcome were extracted. Two reviewers independently extracted data and assessed methodological quality using the Cochrane risk of bias tool.

Data synthesis: Home-based supportive care had a small size effect on physical function (Hedges' g=.17; 95% confidence interval, .09-.26) and a moderate size effect on depressive symptoms (Hedges' g=-.44; 95% confidence interval, -.83 to -.05) in home-dwelling patients after stroke. The moderator analysis revealed that some components of study participants and intervention programs improved the effects on physical function and depressive symptoms; however, no significant moderators were further identified to have superiorly improved physical function and depressive symptoms.

Conclusions: Regular performance of home-based supportive interventions should be considered for inclusion as routine care for managing and improving physical function and depressive symptoms in home-dwelling patients after stroke. The present findings provide further evidence with which to design appropriate supportive interventions for home-dwelling stroke survivors.

Keywords: Depression; Function recovery; House calls; Meta-analysis; Rehabilitation; Social support; Stroke.